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Análise de conformidade em processos de saúde: obesidade no Hospital da Luz de Lisboa
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Resumo(s)
A adoção de protocolos clínicos por parte das organizações de saúde surge da necessidade de reforçar a qualidade do tratamento prestado, aliando as exigências do setor à evolução tecnológica verificada na análise de procedimentos médicos. Tendo em conta a complexidade dos processos clínicos, verifica-se a existência de desvios entre o percurso idealmente percorrido pelo paciente, descrito nos protocolos de prática clínica, e o seu trajeto real, o que acaba por condicionar a qualidade do serviço prestado e, potencialmente, os resultados clínicos obtidos. Desta forma, a avaliação da conformidade existente nos processos de saúde é crucial para que os protocolos clínicos implementados possam ser melhorados e, consequentemente, aumentada a eficiência no tratamento de cada paciente.
O presente estudo tem como objetivo avaliar a conformidade existente entre a prática clínica observada e o percurso clínico pré-estabelecido, recorrendo a técnicas de Process Mining. O modelo proposto avalia a conformidade existente numa amostra de 69 pacientes do Hospital da Luz de Lisboa, que realizaram cirurgia bariátrica como forma de tratamento para a obesidade, utilizando o software ProM.
Tendo em conta os resultados obtidos, não existe evidência de conformidade total com o protocolo clínico, pois foi possível concluir que nenhum paciente cumpre na integralidade o trajeto pré-definido. Verifica-se, assim, um grande espaço para melhoria, uma vez que os valores obtidos para a fitness individual se encontram muito aquém do considerado como satisfatório e, em média, apenas um quarto do trajeto teórico foi concluído pelos pacientes.
The implementation of clinical protocols by health organizations arises from the need to increase the quality of the treatment provided, combining the demands of the sector with the technological evolution verified in the analysis of medical procedures. Considering the complexity of clinical processes, there are deviations between the pathway ideally taken by the patient, described in the clinical practice protocols, and their actual pathway, which ultimately affect the quality of the service provided and, potentially, the clinical outcomes. In this way, the evaluation of existing conformance in health processes is crucial so that the implemented clinical protocols can be improved and, consequently, the efficiency in the treatment of each patient increases. This study intends to evaluate the existing conformance between the observed clinical practice and the pre-established clinical pathway, using Process Mining techniques. The proposed model evaluates the existing compliance in a sample of 69 clinical cases from Hospital da Luz de Lisboa, who underwent bariatric surgery as a form of treatment for obesity, using the Process Mining software - ProM. Taking into account the obtained results, it was concluded that no patient fully complies with the pre-defined pathway, with no evidence of full conformance with the clinical protocol. There is a large room for improvement, since the values obtained for the individual fitness fall far short of what is considered satisfactory and, on average, only a quarter of the theoretical pathway was completed by the patients.
The implementation of clinical protocols by health organizations arises from the need to increase the quality of the treatment provided, combining the demands of the sector with the technological evolution verified in the analysis of medical procedures. Considering the complexity of clinical processes, there are deviations between the pathway ideally taken by the patient, described in the clinical practice protocols, and their actual pathway, which ultimately affect the quality of the service provided and, potentially, the clinical outcomes. In this way, the evaluation of existing conformance in health processes is crucial so that the implemented clinical protocols can be improved and, consequently, the efficiency in the treatment of each patient increases. This study intends to evaluate the existing conformance between the observed clinical practice and the pre-established clinical pathway, using Process Mining techniques. The proposed model evaluates the existing compliance in a sample of 69 clinical cases from Hospital da Luz de Lisboa, who underwent bariatric surgery as a form of treatment for obesity, using the Process Mining software - ProM. Taking into account the obtained results, it was concluded that no patient fully complies with the pre-defined pathway, with no evidence of full conformance with the clinical protocol. There is a large room for improvement, since the values obtained for the individual fitness fall far short of what is considered satisfactory and, on average, only a quarter of the theoretical pathway was completed by the patients.
Descrição
Mestrado Bolonha em Métodos Quantitativos para a Decisão Económica e Empresarial
Palavras-chave
Análise de Conformidade Clinical Pathway Event Log Process Mining Obesidade Cirurgia Bariátrica Conformance Analysis Obesity Bariatric Surgery
Contexto Educativo
Citação
Vitorino, Carolina Vidinha (2022). “Análise de conformidade em processos de saúde: obesidade no Hospital da Luz de Lisboa". Dissertação de Mestrado. Universidade de Lisboa. Instituto Superior de Economia e Gestão.
Editora
Instituto Superior de Economia e Gestão